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200917 Work toward greatness. LUBIN SCHOOLOF BUSINESS VISITING STUDENT APPLICATION Please submit this application with a $ 65 nonrefundable application fee to the appropriate Office of Graduate Admission, accompa-nied by a sealed envelope containing an original statement from the graduate school in which you are currently enrolled which includes the following: 1. The graduate degree program in which you are matriculated; 2. Verification that you are a graduate student in good standing; and 3. An official university seal or signature. Name _____________________________________________________________________________________________________________ First Middle Last Present Address____________________________________________________________________________________________________ Street City State Zip Home Telephone (________) _________________________________ Business Telephone (________) ________________________________ Area Code / Number Area Code / Number Fax(________) _________________________________ E- mail ________________________________ Area Code / Number Institution Currently Attending ____________________________________________________________________________________________________________ Name Location Semester in which you wish to enroll: n Fall _______ n Spring _______ n Summer I _______ n Summer II _______ YearYearYearYear Campus: n New York City n White Plains Graduate program you wish to attend: DYSON COLLEGE OF ARTS AND SCIENCES n Counseling n Environmental Science n Forensic Science n Psychology n Publishing n Public Administration n LUBIN SCHOOLOF BUSINESS n SEIDENBERG SCHOOLOF COMPUTER SCIENCE AND INFORMATION SYSTEMS n SCHOOLOF EDUCATION n LIENHARD SCHOOLOF NURSING You may register for a maximum of TWO COURSES on a space- available basis. Courses must be completed in the semester indicated above. ________________________________________________________________________ Course NumberTitle ________________________________________________________________________ Course NumberTitle Have you ever applied to or enrolled in any graduate program at Pace University? n Yes n No If yes, please indicate: Semester _______________________ Year ___________ Program __________________________________ I certify that all of the information provided by me or on my behalf in support of my application for admission is complete and accurate. I acknowledge that I am obligated to supplement my application as soon as I know or reasonably should know if the information I have provided or that was provided on my behalf is inaccurate or incomplete. I also certify that the personal statement submitted in support of my application for admission is solely my own original work. I acknowledge that Pace University may, at its sole discretion, verify any information submitted in conjunction with my application. I acknowledge that if I omit relevant information or provide inaccurate information or information that is misleading, submit a personal statement that is not solely my own original work, or of I fail to supplement my application as required, Pace University may, at its sole discretion, deny my application for admission, rescind my admission, impose disciplinary sanctions against me, dismiss me from Pace University, and/ or rescind any degrees or certificates awarded to me by Pace University. I acknowledge that the application fee I have paid or will pay in the future is not refundable. I acknowledge that I am bound by the policies, practices, and procedures of Pace University, whether published or unpublished, and I agree to comply with them. Date__________/__________/__________/ ________________________________________________________________________ MonthDayYearSignature of Applicant